Journal Description
Medicines
Medicines
is an international, peer-reviewed, open access journal that covers all medical disciplines and sub-specialties and is published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within PubMed, PMC, CAPlus / SciFinder, and many other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision provided to authors approximately 21.8 days after submission; acceptance to publication is undertaken in 3.6 days (median values for papers published in this journal in the second half of 2021).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Latest Articles
Osteopathic Manipulative Medicine: A Brief Review of the Hands-On Treatment Approaches and Their Therapeutic Uses
Medicines 2022, 9(5), 33; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9050033 - 27 Apr 2022
Abstract
Osteopathic manipulative medicine (OMM) is an emerging practice in the healthcare field with increasing popularity and evidence-based therapy. Osteopathic manipulative treatments (OMT) include hands-on manipulations of different body structures to increase systemic homeostasis and total patient well-being. Indeed, this new realm of the
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Osteopathic manipulative medicine (OMM) is an emerging practice in the healthcare field with increasing popularity and evidence-based therapy. Osteopathic manipulative treatments (OMT) include hands-on manipulations of different body structures to increase systemic homeostasis and total patient well-being. Indeed, this new realm of the whole patient-based approach is being taught in osteopathic schools around the country, and the osteopathic principles of a mind-body-spirit-based treatment are being instilled in many new Doctor of Osteopathy (D.O.) students. However, despite their proven therapeutic value, there are still many individuals, both in and outside the medical profession, who are unaware (or misinformed) of the therapeutic uses and potential benefits of OMT. Here, we provide a brief introduction to this osteopathic therapeutic approach, focusing on the hands-on techniques that are regularly implemented in the clinical setting. It is becoming increasingly evident that different OMTs can be implemented to enhance patient recovery, both alone and in conjunction with the targeted therapies used in allopathic regimens. Therefore, it may be beneficial to inform the general medical community and educate the public and those associated with the healthcare field about the benefits of using OMT as a treatment modality. OMT is lower-cost, noninvasive, and highly effective in promoting full-body healing by targeting the nervous, lymphatic, immune, and vascular systems. There is a growing body of literature related to osteopathic research and the possible molecular pathways involved in the healing process, and this burgeoning field of medicine is expected to increase in value in the healthcare field. This brief review article explains the frequently utilized OMT modalities and their recognized therapeutic benefits, which underscore the need to understand the possible molecular mechanisms and circulating biomarkers linked to the systemic benefits of osteopathic medicine.
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(This article belongs to the Special Issue Updates on Naturopathic and Osteopathic Medicines: The Coming of Age of Age-Old Remedies)
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Open AccessArticle
Epidemiology and Clinical Characteristics of People with Confirmed SARS-CoV-2 Infection during the Early COVID-19 Pandemic in Saudi Arabia
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Medicines 2022, 9(5), 32; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9050032 - 21 Apr 2022
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This study provides epidemiologic and clinical characteristics of 492 consecutive patients diagnosed with SARS-CoV-2 infection at King Faisal Specialist Hospital and Research Centre in Saudi Arabia between March and September 2020. Data were collected from electronic case reports. The cohort was 54% male,
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This study provides epidemiologic and clinical characteristics of 492 consecutive patients diagnosed with SARS-CoV-2 infection at King Faisal Specialist Hospital and Research Centre in Saudi Arabia between March and September 2020. Data were collected from electronic case reports. The cohort was 54% male, with 20.4% aged >60 years, 19.9% aged 31–40 years, and 17% aged 41–50 years. The median incubation period was 16 days, with upper and lower 95% quartiles of 27 and 10 days, respectively. Most patients (79.2%) were symptomatic. Variables significantly different between symptomatic and asymptomatic patients were age, blood oxygen saturation percentage, hemoglobin level, lymphocyte count, neutrophil to lymphocyte (NTL) ratio, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) level. Asymptomatic patients were mostly younger, with lower body mass index and ALT and AST levels but higher lymphocyte counts, NTL ratio, and CD4, CD8, natural killer cell, IgG, and IgM levels. Factors associated with increased risk of mortality were age (>42 years) and comorbidities, particularly diabetes mellitus and hypertension. Patients who were not given an antiviral regimen were associated with better prognosis than patients who received an antiviral regimen (HR, 0.07; 95% CI, 0.011–0.25). These findings will help clinicians and policymakers adopt best management and treatment options for SARS-CoV-2 infection.
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Open AccessCase Report
Unforeseen Outcomes Post Treatment for Radiation Induced Trismus: A Case Report
Medicines 2022, 9(5), 31; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9050031 - 19 Apr 2022
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Post radiotherapy radiation trismus presents significant concerns for a patient’s quality of life and for the clinical monitoring for recurrence of head and neck oncology. Current treatments include scar band release surgery that has been shown to be safe and effective. We present
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Post radiotherapy radiation trismus presents significant concerns for a patient’s quality of life and for the clinical monitoring for recurrence of head and neck oncology. Current treatments include scar band release surgery that has been shown to be safe and effective. We present a case with a rare, post-operative complication of difficulty of mouth closure that can pose a significant impact on quality of life that should be considered.
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Open AccessCase Report
Meningioma Cell Invasion into DuraGen-Derived Dura Mater: A Case Report
Medicines 2022, 9(4), 30; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9040030 - 11 Apr 2022
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Background: Dura mater infiltration is the main growth pattern of meningiomas. Local recurrence may occur in any type of meningioma, but it is more likely so in atypical meningiomas. Therefore, a wide resection of tumor cell-invaded dura mater is necessary to avoid recurrence.
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Background: Dura mater infiltration is the main growth pattern of meningiomas. Local recurrence may occur in any type of meningioma, but it is more likely so in atypical meningiomas. Therefore, a wide resection of tumor cell-invaded dura mater is necessary to avoid recurrence. DuraGen® (an artificial dural substitute) can be used for dural reconstruction in meningiomas. Here, we report a rare case of a patient with atypical meningioma that invaded into the DuraGen®-derived mature dura mater. Case presentation: A 66-year-old female showed a three-time recurrence of atypical meningioma. Simpson grade I resection (en bloc tumor with autologous dura mater and DuraGen®-derived dura mater resection) was achieved at the 3rd recurrence. Collagen fibers running regularly and transversely were observed in the DuraGen®-derived dura mater resembling the autologous meningeal layer. Meningioma cell invasion, displayed by occasional EMA immunostaining, was observed in the DuraGen®-derived dura mater. Conclusions: This case indicates that meningioma cells may invade and survive in the DuraGen®-derived dura mater. Whether or not DuraGen® is not appropriate as a dural substitute remains unanswered. Further experiences are needed to validate these findings in large sample sizes.
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Open AccessArticle
Thyroid Dysfunction among Hypertensive Pregnant Women in Warri, Delta State, Nigeria
Medicines 2022, 9(4), 29; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9040029 - 07 Apr 2022
Abstract
The hypertensive pregnant woman is at a higher risk of complications either before, during or after birth and the baby can be adversely affected leading to preterm birth, low birth weight, placental separation (abruption) and other complications. The aim of the study was
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The hypertensive pregnant woman is at a higher risk of complications either before, during or after birth and the baby can be adversely affected leading to preterm birth, low birth weight, placental separation (abruption) and other complications. The aim of the study was to evaluate thyroid dysfunction among pregnant women with hypertension. The study participants were 150 hypertensive pregnant women, 25 non-hypertensive pregnant women and 25 non-hypertensive non-pregnant women. Exactly 5mL of blood was collected and used for the assay of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) using the enzyme-linked immunosorbent assay technique. Data were analyzed using appropriate statistical tools. The results showed a significantly higher (p < 0.05) age among hypertensive pregnant women when compared with non-hypertensive pregnant women and non-hypertensive non-pregnant women. The serum TSH was significantly higher (p < 0.035) among hypertensive pregnant women when compared with non-hypertensive pregnant women. The triiodothyronine (T3) of hypertensive pregnant women was observed to be significantly higher (p < 0.05) when compared with both non-hypertensive pregnant women and non-hypertensive non-pregnant women. Some 15/150 (10%) of hypertensive pregnant women had subclinical hypothyroidism, 13/150 (8.7%) had overt hypothyroidism, while 122/150 (81.3%) were euthyroid. Among those with thyroid dysfunction, five and four of the subjects had subclinical hypothyroidism and overt hypothyroidism during the second trimester, while ten and nine had subclinical hypothyroidism and overt hypothyroidism during the third trimester, respectively. Evaluation of hypertensive pregnant women for thyroid function may be routinely performed to enable early diagnosis and treatment.
Full article
(This article belongs to the Section Endocrinology and Metabolic Disorders)
Open AccessArticle
JUUL™ing and Heating Lead to a Worsening of Arterial Stiffness
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Medicines 2022, 9(4), 28; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9040028 - 05 Apr 2022
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Background: The widespread use of the JUUL™ device ignited a discussion about the effects these products have on harm reduction. Therefore, we conducted a study directly comparing the JUUL™ device with a cigarette, a heated tobacco product, and a nicotine-free e-cigarette to
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Background: The widespread use of the JUUL™ device ignited a discussion about the effects these products have on harm reduction. Therefore, we conducted a study directly comparing the JUUL™ device with a cigarette, a heated tobacco product, and a nicotine-free e-cigarette to examine the acute effects on arterial stiffness. Methods: This crossover-designed study examines 20 occasional smokers (age 25.2 ± 2.5 years). Study participants used each of the four smoking devices for a duration of 5 min following a protocol. Peripheral blood pressure and parameters of arterial stiffness and endothelial vasodilator function such as the reactive hyperemia index and the augmentation index were measured using the EndoPAT™2000 before and after. Results: In addition to significant peripheral hemodynamic changes after 5 and 10 min (p < 0.05), the reactive hyperemia index showed a significant decrease for all devices 15 min after consumption and remained significantly decreased after 60 min (p < 0.01). The augmentation index adjusted for a heart rate of 75 bpm increased significantly for all devices 15 and 60 min after consumption (p < 0.01). Conclusions: In conclusion, the increases in blood pressure and arterial stiffness are similar after smoking, JUUL™ing, heating, and vaping. These changes may be associated with an increase in cardiovascular risks; however, an evaluation of the long-term effects of JUUL™ing, vaping and heating is needed.
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Open AccessCase Report
A Lurking Threat of Community-Acquired Acinetobacter Meningitis—A Rare Case Report from Punjab, India
Medicines 2022, 9(4), 27; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9040027 - 31 Mar 2022
Abstract
Background: Acinetobacter spp. are a potential life-threatening cause of severe meningitis noted as a nosocomial infection after neurosurgical procedures in patients admitted to neurosurgical ICUs. Community-acquired Acinetobacter meningitis is extremely rare, and only a few cases have been reported in the literature.
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Background: Acinetobacter spp. are a potential life-threatening cause of severe meningitis noted as a nosocomial infection after neurosurgical procedures in patients admitted to neurosurgical ICUs. Community-acquired Acinetobacter meningitis is extremely rare, and only a few cases have been reported in the literature. Case presentation: In this study, we report a patient from Punjab, India, who was infected after a roadside accident in which he developed CSF otorrhea and subsequent meningitis with Acinetobacter lwoffii. The patient was managed with the cephalosporin group of antibiotics as per the sensitivity report. For the first time, we report a rare case report of community-acquired Acinetobacter meningitis from Punjab, India. Conclusions: This case report highlights the potential pathogenicity of Acinetobacter lwoffii and increases concerns that this organism might rapidly evolve into a dreadful antibiotic-resistant community pathogen.
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(This article belongs to the Section Neurology and Neurologic Diseases)
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Open AccessArticle
Efficacy and Adverse Events of Carboplatin Desensitisation Therapy for Gynaecological Cancer: A Retrospective Study
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Medicines 2022, 9(4), 26; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9040026 - 30 Mar 2022
Abstract
Background: Carboplatin, the key drug used in treating gynaecological cancer, has an approximately 12–16% risk of hypersensitivity reactions. We aimed to investigate the efficacy and adverse effects of carboplatin desensitisation therapy for gynaecological cancer. Methods: The desensitisation protocol was standardised as a four-step,
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Background: Carboplatin, the key drug used in treating gynaecological cancer, has an approximately 12–16% risk of hypersensitivity reactions. We aimed to investigate the efficacy and adverse effects of carboplatin desensitisation therapy for gynaecological cancer. Methods: The desensitisation protocol was standardised as a four-step, 4-h, carboplatin administration in the hospital. A retrospective medical record review was conducted on 15 patients who underwent carboplatin desensitisation for gynaecological malignancies at our hospital. Patients’ data were analysed to evaluate the treatment success rate, therapeutic effect of desensitisation, adverse events, and treatment. Results: Of 91 carboplatin desensitisation cycles scheduled; the completion rate was 93.4% (85/91). Adverse events occurred in 23 of these 91 (25.3%). In four (4.4%) of the 23 cycles, hypersensitivity reactions could be treated only by discontinuing the infusion and slowing the administration, while in the remaining 19 (20.9%), medication was administered intravenously after discontinuing the infusion to manage hypersensitivity reactions. No treatment-related deaths occurred. Overall, 23 series of anti-cancer agent regimens, including carboplatin desensitisation, were administered to the 15 patients. The therapeutic response rate was 82.6% and the disease control rate was 95.7%. Conclusions: Carboplatin desensitisation was beneficial in patients with a history of carboplatin-induced hypersensitivity reactions.
Full article
Open AccessCase Report
Novel PKD2 Missense Mutation p.Ile424Ser in an Individual with Multiple Hepatic Cysts: A Case Report
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Medicines 2022, 9(4), 25; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9040025 - 29 Mar 2022
Abstract
We report a novel missense mutation, p.Ile424Ser, in the PKD2 gene of an autosomal dominant polycystic kidney disease (ADPKD) patient with multiple liver cysts. A 57-year-old woman presented to our university hospital with abdominal fullness, decreasing appetite, and dyspnea for three months. A
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We report a novel missense mutation, p.Ile424Ser, in the PKD2 gene of an autosomal dominant polycystic kidney disease (ADPKD) patient with multiple liver cysts. A 57-year-old woman presented to our university hospital with abdominal fullness, decreasing appetite, and dyspnea for three months. A percutaneous drainage of hepatic cysts was performed with no significant symptomatic relief. A computed tomography (CT) scan revealed a hepatic cyst in the lateral portion of the liver with appreciable compression of the stomach. Prior to this admission, the patient had undergone three drainage procedures with serial CT-based follow-up of the cysts over the past 37 years. With a presumptive diagnosis of extrarenal manifestation of ADPKD, we performed both a hepatic cystectomy and a hepatectomy. Because the patient reported a family history of hepatic cysts, we conducted a postoperative genetic analysis. A novel missense mutation, p.Ile424Ser, was detected in the PKD2 gene. Mutations in either the PKD1 or PKD2 genes account for most cases of ADPKD. To the extent of our knowledge, this point mutation has not been reported in the general population. Our in-silico analysis suggests a hereditary likely pathogenic mutation.
Full article
(This article belongs to the Section Endocrinology and Metabolic Disorders)
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Open AccessCase Report
Unusual Presentation of Bouveret Syndrome Resulting in Both Gastric Outlet Obstruction and Small Bowel Obstruction with Perforation
Medicines 2022, 9(3), 24; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030024 - 15 Mar 2022
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Our case describes an 83-year-old female who presented with severe abdominal pain, nausea, and bilious emesis of one day’s duration. She had an endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and percutaneous transhepatic biliary drainage (PTCD) one year prior for choledocholithiasis with acute cholangitis
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Our case describes an 83-year-old female who presented with severe abdominal pain, nausea, and bilious emesis of one day’s duration. She had an endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and percutaneous transhepatic biliary drainage (PTCD) one year prior for choledocholithiasis with acute cholangitis in her home country, Scotland. Unfortunately, while visiting family in the United States, her PTCD became dislodged, and she developed progressive worsening abdominal pain. Computerized tomography of her abdomen showed pneumobilia, perigastric inflammation, a contracted gallbladder, small bowl inflammation with a likely transition point at the mid-jejunum, and a probable duodenal mass. The patient underwent an exploratory laparotomy with intraoperative findings of choledochoduodenal fistula with coincident gastric and small bowel obstruction (SBO) secondary to three large, mixed gallstones. One 3 cm gallstone was located at the pylorus and two (2.3 and 3 cm) gallstones were isolated in the mid-jejunum, with one of those causing isolated transmural pressure necrosis with subsequent perforation. Bouveret syndrome is a rare cause of gastric outlet obstruction (GOO) that manifests via an acquired cholecystoenteric fistula. Our patient presented with a concomitant GOO and SBO with perforation of the mid-jejunum. Timely diagnosis of Bouveret syndrome is essential, as most causes require emergent surgical intervention.
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Open AccessEditorial
Drug-Induced Sexual Dysfunction in Individuals with Epilepsy: Beyond Antiepileptic Compounds
Medicines 2022, 9(3), 23; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030023 - 14 Mar 2022
Abstract
Sexual dysfunction (SD) is a multifactorial problem, involving neurological, iatrogenic, endocrine, psychiatric, and psychosocial factors, and affects the quality of life of both male and female individuals with epilepsy [...]
Full article
(This article belongs to the Section Neurology and Neurologic Diseases)
Open AccessReview
Wen Dan Tang: A Potential Jing Fang Decoction for Headache Disorders?
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Medicines 2022, 9(3), 22; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030022 - 04 Mar 2022
Abstract
Background: Chinese herbal medicine is considered relatively safe, inexpensive, and easily accessible. Wen Dan Tang (WDT), a Jing Fang ancient classical Chinese herbal formula with a broad indication profile has been used for several centuries in China to treat various illnesses. Question: Are
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Background: Chinese herbal medicine is considered relatively safe, inexpensive, and easily accessible. Wen Dan Tang (WDT), a Jing Fang ancient classical Chinese herbal formula with a broad indication profile has been used for several centuries in China to treat various illnesses. Question: Are there evidence-based clinical trials that show that WDT has a significant impact on the treatment of various diseases, especially in patients with migraine and tension-type headaches (TTH)? Methods: This study is based on an online database search using PubMed, Medline, Cochrane Library, AcuTrials, Embase, Semantic Scholar, Jstor, internet research, and review of ancient and modern Chinese medical textbooks regarding WDT and its compounds. Results: There were no studies on WDT in migraine and TTH; therefore, this work gathers and describes data for every single compound in the formula. Conclusion: This study suggests that the bioactive compounds found in WDT composition show potential in treating patients with neurological, psychiatric disorders, cardiovascular diseases, metabolic syndrome, and digestive disorders. Some coherence between WDT in headache reduction and improvements in the quality of life in patients with migraines and TTH could be evaluated, showing positive results of WDT in these patients.
Full article
Open AccessCase Report
Acquired Hemophilia A: A Permanent Challenge for All Physicians
Medicines 2022, 9(3), 21; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030021 - 02 Mar 2022
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Acquired hemophilia A (AHA) is a rare disease with a prevalence in Europe of 1.5 per million. This diagnosis is significantly delayed in about one-third of all cases, leading to deferred treatment. The main signs of AHA are spontaneous bleeding seen in about
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Acquired hemophilia A (AHA) is a rare disease with a prevalence in Europe of 1.5 per million. This diagnosis is significantly delayed in about one-third of all cases, leading to deferred treatment. The main signs of AHA are spontaneous bleeding seen in about two-thirds of all patients. AHA can be lethal in 20% of all symptomatic cases. This patient population’s main standard laboratory finding is a prolonged aPTT (activated prothrombin Time) with otherwise normal coagulation results. In addition, antibodies against FVIII (in Bethesda Units) and a quantitative reduction of FVIII activity are necessary to confirm AHA. The therapy of acute bleeding related to AHA is based on the following main principles: Pharmacologic control of the bleeding is of absolute importance. It can be achieved by administering either recombinant activated FVIIa “bypass therapy”; activated prothrombin complex; or Emicizumab, a bispecific monoclonal antibody. Eradication of the FVIII antibodies should be initiated simultaneously. The combination of steroids with cyclophosphamide leads to the highest eradication rates. Causes of AHA may be related to neoplasms, autoimmune diseases, and pregnancy. We report on a patient who underwent four surgical procedures before the diagnosis of AHA was established.
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Open AccessReview
Salubrious Effects of Green Tea Catechins on Fatty Liver Disease: A Systematic Review
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Medicines 2022, 9(3), 20; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030020 - 01 Mar 2022
Abstract
Epigallocatechin-3-gallate (EGCG) is a polyphenol green tea catechin with potential health benefits and therapeutic effects in non-alcoholic fatty liver disease (NAFLD), a common liver disorder that adversely affects liver function and lipid metabolism. This systematic review surveyed the effects of EGCG or green
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Epigallocatechin-3-gallate (EGCG) is a polyphenol green tea catechin with potential health benefits and therapeutic effects in non-alcoholic fatty liver disease (NAFLD), a common liver disorder that adversely affects liver function and lipid metabolism. This systematic review surveyed the effects of EGCG or green tea extract (GTE) on NAFLD reported in studies involving rodent models or humans with a focus on clinicopathologic outcomes, lipid and carbohydrate metabolism, and inflammatory, oxidative stress, and liver injury markers. Articles involving clinical efficacy of EGCG/GTE on human subjects and rodent models were gathered by searching the PUBMED database and by referencing additional articles identified from other literature reviews. EGCG or GTE supplementation reduced body weight, adipose tissue deposits, and food intake. Mechanistically, the majority of these studies confirmed that EGCG or GTE supplementation plays a significant role in regulating lipid and glucose metabolism and expression of genes involved in lipid synthesis. Importantly, EGCG and GTE supplementation were shown to have beneficial effects on oxidative stress-related pathways that activate pro-inflammatory responses, leading to liver damage. In conclusion, green tea catechins are a potentially useful treatment option for NAFLD. More research is required to determine the ideal dosage, treatment duration, and most effective delivery method of EGCG or GTE, and to provide more definitive conclusions by performing large, randomized clinical trials.
Full article
(This article belongs to the Special Issue Perspective of Metabolism: Potential Therapeutic Targets of Metabolic Diseases such as Obesity-Associated Diabetes, Atherosclerosis and Fatty Liver)
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Open AccessReview
Novel Psychoactive Substances: The Razor’s Edge between Therapeutical Potential and Psychoactive Recreational Misuse
Medicines 2022, 9(3), 19; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030019 - 01 Mar 2022
Abstract
Background: Novel psychoactive substances (NPS) are compounds of natural and synthetic origin, similar to traditional drugs of abuse. NPS are involved in a contemporary trend whose origin lies in a thinner balance between legitimate therapeutic drug research and legislative control. The contemporary NPS
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Background: Novel psychoactive substances (NPS) are compounds of natural and synthetic origin, similar to traditional drugs of abuse. NPS are involved in a contemporary trend whose origin lies in a thinner balance between legitimate therapeutic drug research and legislative control. The contemporary NPS trend resulted from the replacement of MDMA by synthetic cathinones in ‘ecstasy’ during the 2000s. The most common NPS are synthetic cannabinoids and synthetic cathinones. Interestingly, during the last 50 years, these two classes of NPS have been the object of scientific research for a set of health conditions. Methods: Searches were conducted in the online database PubMed using boolean equations. Results: Synthetic cannabinoids displayed protective and therapeutic effects for inflammatory, neurodegenerative and oncologic pathologies, activating the immune system and reducing inflammation. Synthetic cathinones act similarly to amphetamine-type stimulants and can be used for depression and chronic fatigue. Conclusions: Despite the scientific advances in this field of research, pharmacological application of NPS is being jeopardized by fatalities associated with their recreational use. This review addresses the scientific achievements of these two classes of NPS and the toxicological data, ending with a reflection on Illicit and NPS control frames.
Full article
(This article belongs to the Section New Drugs Exploration and Development)
Open AccessReview
The Impact of Industry Funding on Randomized Controlled Trials of Biologic Therapies
Medicines 2022, 9(3), 18; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030018 - 28 Feb 2022
Abstract
Background: There has been substantial interest from the pharmaceutical industry to study and develop new biologic agents. Previous studies outside of the biologics field have demonstrated that industry funding has the potential to impact the design and findings of clinical trials. The objective
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Background: There has been substantial interest from the pharmaceutical industry to study and develop new biologic agents. Previous studies outside of the biologics field have demonstrated that industry funding has the potential to impact the design and findings of clinical trials. The objective of this study was to evaluate the impact of industry funding on randomized controlled trials (RCTs) that investigated the efficacy of biologic therapies. Methods: A review of all RCTs involving biologic therapies in top impact factor medical journals from January 2018 to December 2020 was performed. The relationship between industry funding and the presence of statistically significant primary outcomes and the use of active comparators were analyzed. Results: Among the 157 RCTs included, 120 (76%) were industry funded and 37 (24%) declared no industry funding. Industry-funded studies were significantly more likely to report a statistically significant positive primary outcome compared to studies without industry funding (85% vs. 67%, χ2 = 5.867, p = 0.015) and were significantly more likely to utilize placebo or no comparator than non-industry-funded trials (78% vs. 49%, χ2 = 4.430, p = 0.035). Conclusions: Industry-funded trials investigating biologic therapies are more likely to yield statistically significant positive outcomes and use placebo comparators when compared to non-industry-funded biologic therapy trials in high-impact medical journals.
Full article
Open AccessArticle
Investigating Prescription Medication Expenditures and Level of Perceived Health Status among Older Adults with Pain in the United States
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Medicines 2022, 9(3), 17; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9030017 - 22 Feb 2022
Abstract
Background: the objective of this retrospective, cross sectional study was to assess the relationship between different levels of perceived health status and prescription medication expenditures among United States adults aged ≥50 years with self-reported pain. Methods: using 2019 Medical Expenditure Panel Survey (MEPS)
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Background: the objective of this retrospective, cross sectional study was to assess the relationship between different levels of perceived health status and prescription medication expenditures among United States adults aged ≥50 years with self-reported pain. Methods: using 2019 Medical Expenditure Panel Survey (MEPS) data, four levels of perceived health status were formed (excellent, very good, good, and fair/poor health). Differences between characteristics in the groups were compared using chi square tests. Adjusted linear regression models, using logged positive annual prescription medication expenditures, were constructed to assess differences in prescription medication expenditures between levels of perceived health. Results: a total of 4826 individuals were included in the study. Adjusted linear regression analysis indicated those who reported excellent health had 65.8% lower annual prescription medication expenditures than those with fair/poor health. Those with very good health had 49.7% lower annual prescription medication expenditures than those with fair/poor health, while those with good health had 27.2% lower annual prescription medication expenditures than those with fair/poor health. Conclusions: better perceived health status was generally associated with relatively lower prescription medication expenditures. Further research is needed to investigate if this pattern is also observed for other categories of healthcare expenditures and in other populations.
Full article
(This article belongs to the Special Issue Medicines: Identifying, Exposing and Tackling Unethical and Corrupt Practices is Essential for Safeguarding Patient and Public Health Interests Worldwide)
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Open AccessReview
Neurogenic Dysphagia and Nutrition in Disorder of Consciousness: An Overview with Practical Advices on an “Old” but Still Actual Clinical Problem
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Medicines 2022, 9(2), 16; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9020016 - 21 Feb 2022
Abstract
Neurogenic dysphagia is a difficulty in swallowing food caused by disease or impairment of the nervous system, including stroke and traumatic brain injury. The most clinically apparent complication of neurogenic dysphagia is pulmonary aspiration, which may manifest itself acutely as choking or coughing,
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Neurogenic dysphagia is a difficulty in swallowing food caused by disease or impairment of the nervous system, including stroke and traumatic brain injury. The most clinically apparent complication of neurogenic dysphagia is pulmonary aspiration, which may manifest itself acutely as choking or coughing, respiratory distress, wheezing, gasping or gurgling, and tachycardia. However, chronic symptoms, including weight loss, production of excessive oral secretions and aspiration pneumonia, may be also present, especially in patients with a disorder of consciousness (DOC). Usually, patients with dysphagia after the acute phase need to be treated with enteral nutrition using a feeding tube. This avoids patient malnutrition and supports the rehabilitation program. This narrative review aims to investigate dysphagia and its complications and management in patients with DOC. Clinical indications and practical advice on how to assess and treat this complex problem are also provided.
Full article
(This article belongs to the Special Issue Frailty Syndrome in the Elderly: a Real Challenge for Our Society)
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Open AccessArticle
Early Time-Restricted Feeding Amends Circadian Clock Function and Improves Metabolic Health in Male and Female Nile Grass Rats
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Medicines 2022, 9(2), 15; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9020015 - 21 Feb 2022
Abstract
Lengthening the daily eating period contributes to the onset of obesity and metabolic syndrome. Dietary approaches, including energy restriction and time-restricted feeding, are promising methods to combat metabolic disorders. This study explored the effect of early and late time-restricted feeding (TRF) on weight
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Lengthening the daily eating period contributes to the onset of obesity and metabolic syndrome. Dietary approaches, including energy restriction and time-restricted feeding, are promising methods to combat metabolic disorders. This study explored the effect of early and late time-restricted feeding (TRF) on weight and adiposity, food consumption, glycemic control, clock gene expression, and liver metabolite composition in diurnal Nile grass rats (NGRs). Adult male and female Nile grass rats were randomly assigned to one of three groups: (1) access to a 60% high-fat (HF) diet ad-libitum (HF-AD), (2) time-restricted access to the HF diet for the first 6 h of the 12 h light/active phase (HF-AM) or (3) the second 6 h of the 12 h light/active phase (HF-PM). Animals remained on their respective protocols for six weeks. TRF reduced total energy consumption and weight gain, and early TRF (HF-AM) reduced fasting blood glucose, restored Per1 expression, and reduced liver lipid levels. Although sex-dependent differences were observed for fat storage and lipid composition, TRF improved metabolic parameters in both male and female NGRs. In conclusion, this study demonstrated that early TRF protocol benefits weight management, improves lipid and glycemic control, and restores clock gene expression in NGRs.
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(This article belongs to the Special Issue Perspective of Metabolism: Potential Therapeutic Targets of Metabolic Diseases such as Obesity-Associated Diabetes, Atherosclerosis and Fatty Liver)
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CHRIST: CD44-Incorporated Hepatocellular Carcinoma Risk Index Scoring Tool—A Novel Prognostic Scoring System for Hepatocellular Carcinoma Development and Aggressiveness
Medicines 2022, 9(2), 14; https://0-doi-org.brum.beds.ac.uk/10.3390/medicines9020014 - 21 Feb 2022
Abstract
CD44 has been demonstrated to play a pivotal role in regulating tumor cell progression, including hepatocellular carcinoma (HCC) development. Here, we aimed to establish a scoring system to evaluate the risk of developing HCC utilizing CD44-rs187115 SNP polymorphism. A prospective cohort of 120
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CD44 has been demonstrated to play a pivotal role in regulating tumor cell progression, including hepatocellular carcinoma (HCC) development. Here, we aimed to establish a scoring system to evaluate the risk of developing HCC utilizing CD44-rs187115 SNP polymorphism. A prospective cohort of 120 individuals was enrolled in four groups: 19 non-metastatic HCC patients, 21 metastatic, 40 patients with hepatitis C-related cirrhosis, and 40 controls. Allelic discrimination of the CD44-rs187115 gene polymorphism was assessed using TaqMan genotyping assay. HCC patients with CT/CC genotypes were more likely to have aggressive malignancy compared to TT carriers. A significant correlation was noted between the existence of CT/CC genotypes and tumor size, multicentricity, infiltration, portal vein thrombosis, and metastasis. A CD44-incorporated Hepatocellular Carcinoma Risk Index Scoring Tool (CHRIST) was formulated utilizing clinical and genetic variables. A score > 3 for HCC development demonstrated 87.5% sensitivity, 72.5% specificity, and a 76% positive predictive value (PPV) and 85% negative predictive value (NPV). Furthermore, a score > 5 for HCC metastasis demonstrated 90.4% sensitivity, 68.4% specificity, a 76% PPV and 86% NPV. A similarly significant score was noted following a six-month re-evaluation. We conclude that CD44-rs187115 may serve as a reliable prognostic biomarker for HCC and that the CHRIST prognostic model is highly predictive of the development of HCC and metastatic HCC.
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(This article belongs to the Section Cancer Biology and Anticancer Therapeutics)
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